This appeared last week.
22 October, 2019
Predictive analytics to keep more aged care residents out of Emergency
New software to analyse the clinical data of aged care residents for signs of deteriorating health could reduce emergency hospitalisations and allow more time for end of life plans.
The clinical decision support software is being developed as part of Telstra Health’s residential aged care software suite, over the next two years, in a $1 million partnership announced today by RMIT University, Telstra Health and the Digital Health Cooperative Research Centre.
Significantly, it will mark the introduction of clinical decision support software to predict deterioration, which is already used in acute care settings, into aged care.
Dr Victor Pantano, CEO of the Digital Health CRC, said the project had enormous potential to keep more aged care residents out of avoidable emergency care, as well as to provide earlier indications when residents are approaching end of life.
“Emergency hospitalisations are not only stressful for aged care residents and their families, but they also place significant additional demand on hospitals,” Dr Pantano said.
“To be able to treat residents earlier, and avert the need for hospitalisation, is extremely important.”
“Similarly, the earlier we can ascertain that an aged care resident is approaching end of life, the earlier we can enact their advance care plan and honor their preferences – an important process for the aged care resident, their carers and families, and the aged care provider.”
Importantly for aged care providers, better prediction of care needs is expected to enable more effective planning for staffing and clinical resources, which has been identified as a crucial factor by providers who use Telstra Health’s aged care software.
RMIT Professor of Computer Science, Lawrence Cavedon, said the research team will work with gerontologists and aged care staff to interpret historical data and develop new predictive analytics techniques, as well as adapting existing decision support methods from the acute care sector.
“Researchers will work closely with clinicians to understand reliable signs of patient deterioration, how this might be identified from recorded data, and to manage any related ethical issues,” Professor Cavedon said.
Telstra Health has offered providers using its software to participate in the research, which has been met with a positive response from several providers.
The new algorithms will first be tested using historical data and then applied to current data in a trial setting. Ultimately, they will be integrated into Telstra Health’s Clinical and Care Management software.
Larissa Briedis from Telstra Health said the community cared deeply about the effectiveness of advanced care plans.
“While most people assume Advanced Care Directives will be enacted, the reality is that often this doesn’t occur, due to a lack of knowledge that end of life is approaching,” Ms Briedis said.
“Use of predictive analytics will enable more aged care providers, residents and their families to enact appropriate plans for end of life, according to the wishes of that person.”
As part of the Digital Health CRC’s Industry-PhD program, a PhD student will be embedded within the team.
“Through this innovative PhD program, we’re also helping build the digital health workforce Australia will need in the future,” Dr Pantano said.
The project is one of many being rolled out over the coming months through the Digital Health CRC, one of the world’s largest digital health R&D cooperatives.
Here is a useful link:
There was also coverage in the technical press here:
Telstra Health, RMIT, CRC aim algorithms at deteriorating health
Want to reduce emergency hospitalisations.
Telstra Health, RMIT and the Digital Health CRC will spend $1 million developing clinical decision support software to predict deteriorating health of people receiving aged care.The software will ultimately form part of Telstra Health’s residential aged care software suite, and is expected to be created over the next two years.
The three organisations said in a statement that they hope to “reduce emergency hospitalisations and allow more time for end of life plans”.
“Emergency hospitalisations are not only stressful for aged care residents and their families, but they also place significant additional demand on hospitals,” Digital Health CRC CEO Dr Victor Pantano said.
Lots more here:
https://www.itnews.com.au/news/telstra-health-rmit-crc-aim-algorithms-at-deteriorating-health-532759
I have to say that this looks like a pretty ‘courageous’ project to me that may have some interesting issues that need to be addressed.
The most obvious to me is just how the data, and what data, is captured to allow an algorithm to determine that deterioration is happening and how frequently it needs to be captured to provide a reasonable time for decisions to be made.
The project seemingly is aiming to provide enough warning for clinicians to be able to act – either to stabilise and avoid transfer to hospital or alternatively to allow nature to take its course – while presumably providing suitable end of life care.
The level of observation and temporal responsiveness seems to me to be a little ahead of just where most aged care facilities as revealed in the ongoing Royal Commission.
I am also not sure into which diagnostic categories older people would fit who were deemed suitable for positive intervention but not sick enough to be transferred to a hospital setting to be more fully stabilised. Obviously the Advanced Care Directives to guide a move to palliation would also need to be carefully thought out and agreed with the patient / relatives. With such plans the actuality of imminent demise also has the possibility of overturning well laid plans and causing all sorts of consent issues.
This all has the feel of a project that a careful ethics committee may raise a zillion questions regarding.
I look forward to more details being provided over time to see just how well it is all working, especially with the data capture and time-frames for action that may be necessary.
What do others think?
David.
6 comments:
Mmmmmm ... the process of dying is part of ageing for many residents. Why is a "computer system" needed to replace the clinician to keep dying people out of hospital? Why are ageing people who are dying in the aged care facility being sent to hospital? What will Telstra's decision support system tell us? Can't doctors make the basic decisions around end of life processes any more? Would someone please enlighten us before we all get too old and start dying. Thanks.
"Dr Victor Pantano, said the project had enormous potential to keep more aged care residents out of avoidable emergency care, as well as to provide earlier indications when residents are approaching end of life."
Get real Dr Pantano. A significant proportion of aged care residents shouldn't be sent to hospital emergency departments and it doesn't require a computer system to tell us that.
Indications of when residents are approaching end of life should be apparent to competent doctors and nurses. Physical examination and routine basic tests conducted over time and discussion with next-of-kin will indicate when a resident is approaching end of life.
Providing "more time for end of lie plans" is a pathetic excuse for avoiding doing what should have been done as part of the admission processes when entering an aged care facility.
Aged Care Facilities do not need more bureaucratic impediments being imposed on them like a computer system to tell them when a resident is dying.
Ye gods, do these technologists live under a rock? Are they just desperate to find a problem for their little toy solutions? Is it easier for the Health Department to pretend they are doing something useful by wasting billions on a dubious document management system?
Technology is largely a distraction from the main problems facing healthcare, especially aged care:
Aged care royal commission interim report holds first clue to what comes after the horror.
https://www.abc.net.au/news/2019-10-31/aged-care-royal-commission-interim-report/11654534
The failures of My Health Record fall into insignificance, but they are all failures just the same.
I am glad others have noticed just how challenged this whole project appears. If it is to proceed it needs a great deal of change and work. I suspect it will not wind up looking much like the original press release - and that this may be a very good thing!
David.
The words "potential" and "promise" have been used for decades to justify vast expenditure on technology, especially IT in healthcare.
The evidence is increasing that physicians are being overwhelmed by data both interpreting it and creating it for health record systems and administrative purposes.
If the ADHA isn't across the evidence they are being derelict in their duty, but their is nothing t suggest, publicly, they even understand the issue never mind what to do about it.
And technology solutions such as AI, machine learning and auto-fill in record systems are creating even more problems.
When the Minister responds to the ANAO review he'd better not try using the words "potential" and "promise", especially when the question gets asked
"Can the Minister explain why billions spent on dubious technology was better than spending it to fix real health problems - like aged and maternity care and the NDIS."
Assuming his minders monitor Twitter he will know the question will get asked. Again and again.
https://twitter.com/Health_Privacy/status/1189690482701434880
This stupidity leads me to wonder "Was there a business case behind this 'decision' including ROI, aales forecast, provision of care costs saved, R&D investment required, or was it all based on "What a good idea, let's use the computer to keep people out of hospital - that'll make the Minister happy."
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